Tuberculosis extrapulmonar: un reto clínico vigente

The two types of clinical presentation of tuberculosis (TB) are pulmonary, which is the most frequent, and extrapulmonary. Although TB prevalence has been coming down, extrapulmonary TB numbers remain stable; with approximately 1’050.000 new cases reported in the world in 2018. It usually presents by hematogenous or lymphatic dissemination of the Mycobacterium tuberculosis complex to other organs. The more often affected organs are pleura, lymph nodes, gastrointestinal tract, bone and joints. Rarely it can affect the central nervous system, urinary tract, upper respiratory airway, pericardium and skin. Clinical manifestations of extrapulmonary TB are heterogeneous due to its paucibacillary nature representing a clinical challenge for clinicians. Diagnostic work up depends on the affected organ, the quality and accessibility of the sample, the sensitivity of the test and the distribution of the mycobacteria in the tissue. EPTB usually respond to standard TB treatment and optimal time duration depends on the organ involved. The purpose of this review is to describe the clinical presentation and diagnosis workup of extrapulmonary TB.